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Thrush and Pregnancy

 
, medical expert
Last reviewed: 19.11.2021
 
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Thrush (candidiasis) - a common disease in women, often found even during pregnancy. The thrush is caused by the fungus Candida (yeast-like) and flows in the genitourinary system of the female body.

Pregnancy is always a strong shake for a woman's body. At this time there are changes in the hormonal background, a decrease in immunity due to the fact that the immune system is redirected to the fetus and is responsible for its preservation and safety. Thus, favorable conditions are created for all kinds of infections to enter the body and develop favorably there.

For the female body, a small amount of Candida fungus is considered normal. Usually it does not appear in any way, as it is in a depressed state due to the work of the immune system. But as soon as a woman becomes pregnant, the fungus finds loopholes due to the above circumstances in order to start active reproduction and increase its number in the body of a woman.

Pregnant women, in comparison with non-pregnant women, have a greater risk that thrush will develop from locally applied suppositories, vaginal tablets with antibiotics.

The fact is that one of the effects of antibiotics is the suppression of both parasitic microorganisms and physiological lactobacilli, which are less stable throughout the period of pregnancy.

Thrush, which occurs during pregnancy, is very rarely transmitted sexually (only 15-20% of patients). Most often, sexual contact is just a trigger mechanism for thrush to develop.

Causes of thrush during pregnancy

The reasons for the development of thrush during pregnancy can be such factors as:

  • Chronic infection in the genitourinary system. When immunity is struggling with chronic inflammation, it can be depleted and manifest, among other things, as a thrush.
  • Presence of chronic diseases in the kidneys, liver and other organs. The mechanism of the immune system reaction is similar to that described above.
  • Thrush can develop due to hormonal disorders: reduced thyroid function, diabetes, obesity.
  • Candidiasis can be triggered by taking hormonal drugs, such as Prednisolone, Dexamethasone, Metipred.
  • The cause of thrush can also be the presence of genital herpes.
  • Thrush can be caused by taking antibiotics, which could cause immunodeficiency and dysbiosis of the intestinal tract. Fungus Candida can often stay in the intestines for a while, it is a kind of reservoir for candidiasis in the body of a woman, and then move to other places.
  • With improper nutrition, for example, an excess of sweets, dysbacteriosis can also develop and fungi can multiply.
  • The cause of thrush may be the presence of chronic diseases of the intestinal tract.
  • Candidiasis can occur due to improper use of drugs such as eubiotics. To treat the flora of the vagina appoint drugs with the content of milk bacteria (lactobacterin, acylact). They live in the vagina in a normal state of the body, are needed to maintain an acidic environment in it, interfere with the development of alkali-loving bacteria, the presence of which can cause bacterial vaginosis. But the environment of milk bacteria is favorable for Candida fungi, therefore it is better to diagnose the absence of fungi before prescribing eubiotics.

Thrush is a kind of marker of unsuccessful conditions of the body, therefore for its elimination it is necessary both specific treatment with the help of antifungal drugs, as well as a thorough examination, as well as elimination of the underlying causes that caused immunodeficiency.

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Symptoms of thrush during pregnancy

The main symptoms of thrush during pregnancy include:

  • itching near the vagina;
  • discharge from the vagina - white, curdled, fairly abundant, with a sourish yeast smell;
  • discomfort in the perineum.

The presence of thrush during pregnancy, like any other infection is potentially dangerous for both the future mother and her baby. The course of pregnancy is complicated, the fungus can infect the fetus.

The fetus is infected through the placental barrier or in the process of delivery. Then it is possible that the baby has a congenital candidiasis stomatitis, candidiasis of the skin.

Therefore, although thrush occurs frequently in pregnant women, its presence is abnormal (although there is an outdated idea that thrush is an ordinary natural and innocuous phenomenon). At the slightest suspicion of a thrush, immediately it is necessary to carry out the diagnosis and prescribe the treatment.

Thrush and itching during pregnancy

Many perceive thrush is not serious, they say, that there is a small discharge and itching. It is important to remember that this is a serious disease that is caused by a special kind of fungus and needs special treatment. In addition, similar symptoms are observed in a number of diseases caused by very different infections, therefore it is extremely necessary to diagnose a specialist who will establish the correct diagnosis and prescribe the appropriate treatment. A trip to the doctor can not be delayed in any case, especially during pregnancy, because candidiasis is dangerous for the child and his health. After a course of appropriate medications prescribed by a doctor, usually a week or two later they do a second smear or conduct a bacteriological (culture) study to determine if the thrush is eliminated during pregnancy.

Diagnosis of thrush during pregnancy

For the diagnosis of thrush during pregnancy, the first study immediately to identify the symptoms of the disease - carrying out a bacterioscopy. A stained smear is treated on the flora with a microscope.

The normal microflora of the vagina is: Dederlein's sticks (milk bacteria). The smear contains them together with the cells of the epithelium and leukocytes in a small amount. When a smear shows spores or mycelial fungus Candida, then the thrush is diagnosed. Sometimes this fungus can be present in single amounts without causing a disease.

When the symptoms characteristic of thrush are present, but the bacterioscopy of fungi does not reveal, resort to more sensitive methods of diagnosis - bacteriological and PRC.

Bacteriological (cultural) method consists in harvesting with a special nutrient medium - the Saburo medium. Its essence lies in the fact that the collected mushroom cells are immediately placed in favorable conditions, because they can immediately start to multiply, thereby confirming that they are present in the smear and are viable, while without being placed in special conditions in the smear they could not show themselves .

The PRC method (poly-chain reaction) is also used. The essence of its action is to detect in the material, which is taken for the study, single DNA molecules of the pathogen. The sensitivity of this method is superior to all other methods used to diagnose the presence of infection. It is used in cases where the pathogen is difficult to detect in a simple smear and which grows poorly in a normal nutrient medium. It is true that this method is rarely used for the diagnosis of thrush, since it is unjustifiably expensive, laborious and often shows a positive result, even when the pathogen is present in small amounts (and in candidiasis, a small amount of fungus can often be quite normal, not causing disease).

Therefore, diagnostics are usually performed after the detection of symptoms with the help of bacterioscopy and (or) sowing.

The thrush does not belong to those classic diseases that are transmitted sexually. Thrush is accompanied by a special internal condition, in which immunity is reduced. Therefore, in cases where candidiasis is sluggish, relapsing and poorly treatable, its cause can be pathology in the body, which is accompanied by immunodeficiency, and manifests itself as a thrush. During pregnancy, the hormonal background decreases due to the fact that the immune system works in a special regime, because this state of affairs in the body favors the development of fungi. Nevertheless, one should always be attentive to the slightest changes in the body and, with the slightest suspicion, carry out a diagnosis in order to start treatment in time and to prevent danger to the body and a favorable course of pregnancy.

Treatment of thrush during pregnancy

Although candidiasis is an internal condition, it is completely sexually transmitted. Therefore, the course of treatment is assigned to both partners, during this period, the use of a condom is necessary for sexual intercourse.

Treatment of thrush is characterized by the use of systemic and local drugs. Systemic drugs are tablets, which the patient takes inwards. Initially, they have an effect on the intestinal environment, then are absorbed into the blood and penetrate to the organs and tissues of the human body. For non-pregnant patients, this is the main and most preferred method, in contrast to the local treatment (candles, creams). The fact is that most of the fungi are in the intestinal tract and for effective treatment they must be destroyed first. Plus, the habitat of the Candida fungus is also the thickness of the vagina walls, where drugs of local use can not be obtained - their area of activity is the surface, they only contribute to reducing the manifestations of the disease, but do not kill the pathogen in full. Systemic drugs act through blood on all organs. However, in pregnancy, not all systemic drugs can be used to treat thrush, many of them are toxic and have side effects. Typically, pregnant women suffering from thrush, of all the systemic drugs prescribed only ineffective "Nystatin" and "Pifamucin."

"Pifamucin" is an antifungal drug that is not harmful during pregnancy and feeding. It is quite effective and not toxic even in small doses. Other drugs related to the systemic ones - Fluconazole (Diflucan), Levorin, Nizoral, and many others - should not be used during pregnancy.

To local treatment include the use of suppositories, vaginal tablets and creams. Usually this method of treatment is combined with systemic drugs, in addition, in pregnancy, it is preferable.

Drugs of local treatment are all the same. Usually a suppository with nystatin, a suppository or a cream with pimafucine is used. The drug "Clotrimazole" ("Kanesten"), which is very often used in the treatment of candidiasis in nonpregnant women, in no case be used during the first trimester of pregnancy, it is undesirable to use it at later dates.

Vaginal tablets and a suppository for treatment of thrush for 10 days are inserted deep into the vagina every night before going to bed.

In addition to the fact that specific antifungal agents are used to treat thrush, it is possible to use antiseptic and anti-inflammatory drugs, which are common in alternative methods of treatment. Widely used solution of sodium tetraborate in glycerin (borax in glycine), as well as ordinary greens. The essence of their action in the mechanical removal of mycelial fungus, living on the walls of the vagina, the suspension of their growth, the provision of anti-inflammatory action, the elimination of complaints and symptoms. Characteristic for the use of these drugs is the absence of side effects, because they are often chosen for treatment during the first trimester of pregnancy, while the use of other drugs is strictly prohibited. The gauze pad is moistened in solution, and then the walls of the vagina are wiped with it.

Iodine preparation "Betadin", widely used for the treatment of thrush in non-pregnant patients, is also contraindicated during fetal gestation - it affects the baby's thyroid gland and can lead to disturbances in its formation.

Although Candida fungus lives in almost every woman's body, and pregnancy predisposes to their reproduction, but not all pregnant women suffer from thrush. First of all, the exacerbation of the yeast infection is affected by immunodeficiency, therefore if candidiasis does not lend itself to easy and definitive treatment, most likely a serious chronic pathology is observed in the body. Therefore, it is important to include general strengthening and immunomodulating medications for the general treatment of the disease. In addition, multivitamins are prescribed, since the presence of hypovitaminosis is a common cause that causes immunodeficiency, contributing to the creation of a favorable background to the side effects of many medications. As immunomodulators, during pregnancy, rectal suppositories containing viferon are used.

If we talk about probiotics that contain useful microorganisms already present in the human body, then during the treatment of thrush you can take only drugs with bifidobacteria. Candidiasis does not contribute to the suppression of lactobacilli, therefore, no additional need to take their needs, plus to all the lactobacillus contribute to an even more active reproduction of fungi.

It is important to remember that the treatment of thrush during pregnancy should be prescribed only by the attending doctor who is familiar with the individual characteristics of the future mother, her propensity for allergies, knows what condition her liver and kidneys are in, how pregnancy is, and what pathologies accompany. It is better not to engage in self-medication at all, and even more so during the gestation of the baby, because incorrect treatment can be dangerous not only to the mother, but also to her child.

The husband of the pregnant woman should also be treated for thrush, it does not matter whether the couple continues their sex life during pregnancy, or not. A man can take any of the effective drugs, including "Fluconazole", "Nizoral" and others.

Preventing thrush during pregnancy

90% of pregnant women have Candidiasis. This disease is very undesirable in the period of gestation, as it can seriously affect not only the course of pregnancy itself, but also the health of the baby's future. There are several simple methods for preventing thrush:

  • Strengthening of immunity. This measure is especially important, since it is immunodeficiency that often becomes the trigger for the multiplication of Candida fungi and the development of the disease. The diet should be enriched with products rich in probiotics: biokefir, yoghurts with live bacteria. Help prevent thrush and prebiotics, such as, for example, bananas and garlic. If you have to be treated with an antibiotic, it is important to ensure that the doctor has prescribed a sparing drug for the intestinal microflora or prescribed medications to mitigate the effects of the antibiotic.
  • Wearing comfortable underwear with free cut, preferably of natural fabrics. Synthetics, due to a tight fit to the body, complicates the circulation of air around the genitals, which favors the creation of ideal conditions for the bacteria to multiply. It is better not to use daily pads, because they also help the fungus to develop.
  • Compliance with hygiene rules. Instead of scented shower gel and soap, it is better to use intimate hygiene products that do not have an odor or mild soap.
  • Conduct a survey for the presence of harmful bacteria. Any infection of the genitals can adversely affect the course of pregnancy and contribute to the development of chronic vaginal candidiasis. Therefore, it is better to worry in advance and eliminate the likelihood of the disease.

Pregnancy planning and thrush

When a woman plans a pregnancy, it is worthwhile to conduct a full examination with a gynecologist, which includes a full set of laboratory tests and, if necessary, pre-cure all existing diseases that can affect the course of pregnancy, the fetus and the health of the baby's future, including thrush. There are cases where a woman infected with a thrush is not protected, believing that she can not become pregnant, since the reproductive system does not seem to work. But this is not true, with thrush it is quite possible to become pregnant. If it so happened that during the activation of the thrush woman has become pregnant, you need to cure the disease as soon as possible. Naturally, the treatment should appoint a doctor, that it was necessarily sparing and at the same time effective, and at the same time suitable for a pregnant woman.

Thrush during pregnancy is dangerous for the health of not only mom, but her baby.

The placenta misses Candida fungus, it can affect internal organs, lead to malformations, premature death of the unborn child. If the fetus becomes infected with thrush in the first trimester of pregnancy, it can be incredibly dangerous for him, up to the point that miscarriage may occur. But if the miscarriage does not happen, infection of the fetus can lead to a strong weakening of the baby's body. A newborn infant infected with thrush is in great danger: unlike an adult, for whom this disease does not represent a serious threat, a child can develop extremely complicated diseases because of her. Often thrush leads to the development of candidal stomatitis, when the causative agent contributes to the disease of the mucous membrane of the oral cavity of the child. Therefore, it is so important to prevent the thrush at the stage of pregnancy planning, so as not to treat it afterwards neither during pregnancy, nor, even more so, after the birth of the child.

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